1. Field of the Invention
The present invention relates to a calculus manipulation apparatus capable of crushing and recovering an object of manipulation, such as a calculus in the body cavity, e.g., the kidney, ureter, urinary bladder, etc., by utilizing ultrasonic vibration.
2. Description of the Related Art
Conventionally, there are various surgical instruments that approach and remove a calculus in the urinary bladder or a ureter through the urethra (refer to Jpn. Pat. Appln. KOKOKU Publication No. 6-38804 (Patent Document 1), for example). A surgical instrument of Patent Document 1 uses an ultrasonic probe to crush a coral calculus that adheres to the kidney. Then, the calculus that is chipped away from the kidney is picked up in a basket and pulverized.
An ultrasonic calculus crusher, kinetic-energy lithotripter, electrohydraulic shock wave lithotripter, etc. are conventionally known as apparatuses that are inserted into the body cavity through a channel of an endoscope and crush a calculus. The ultrasonic calculus crusher crushes the calculus by means of the distal end of a lithotriptic probe that undergoes ultrasonic vibration. The kinetic-energy lithotripter uses compressed air or electromagnetic means to subject a probe to longitudinal vibration and crushes the calculus by utilizing the shock of the vibration. The electrohydraulic shock wave lithotripter crushes the calculus with shock waves based on electric discharge.
FIG. 28 shows an example of the ultrasonic calculus crusher. The ultrasonic calculus crusher comprises a high-frequency power source a, a vibrator b for converting high-frequency power from the power source a into ultrasonic vibration, and an elongate lithotriptic probe c of which the proximal end portion is connected to the vibrator b. The vibration generated by the vibrator b is propagated to the distal end side by means of the lithotriptic probe c. Further, a footswitch d is connected to the high-frequency power source a. A calculus is crushed by ultrasonic vibration in a manner such that the distal end portion of the lithotriptic probe c is brought into contact with the calculus with the probe c in a manipulation channel of the endoscope.
The vibrator b and the lithotriptic probe c are hollow. This hollow pipeline is connected to a suction tube e. The suction tube e is fitted with a roller pump f. In operation, the distal end portion of the lithotriptic probe c of the ultrasonic calculus crusher is brought into contact with the calculus. As this is done, the calculus is crushed by ultrasonic vibration, and at the same time, fragments of the calculus are sucked through the hollow pipeline.
Examples of the kinetic-energy lithotripter are described in Patent Specification No. 3132972 (Patent Document 2) and Jpn. Pat. Appln. KOKAI Publication No. 62-144645 (Patent Document 3). The apparatus of Patent Document 2 transmits a shock produced by compressed air to a lithotriptic probe and crushes a calculus by means of the distal end of the probe. The apparatus of Patent Document 3 transmits a shock produced by an electromagnetic method to a lithotriptic probe and crushes a calculus by means of the distal end of the probe.
FIG. 29A shows an example of the electrohydraulic lithotripter. This apparatus is provided with two electrodes i1 and i2 on a distal end portion h of a soft lithotriptic probe g, as shown in FIG. 29B. A calculus j is crushed with shock waves that are generated when electric discharge is caused between the electrodes i1 and i2.
According to alternative known methods (refer to Jpn. Pat. Appln. KOKAI Publication No. 60-96241 (Patent Document 4) and Jpn. Pat. Appln. KOKAI Publication No. 5-111493 (Patent Document 5), for example), a calculus is crushed mechanically by means of a basket forceps or by ultrasonic vibration. These methods cannot ensure a satisfactory crushing force.
Means for holding down a calculus is described in Jpn. UM Appln. KOKAI Publication No. 63-84215 (Patent Document 6) and Jpn. UM Appln. KOKAI Publication No. 63-84216 (Patent Document 7). This means efficiently applies shock waves to a calculus in crushing it and holds it down lest it move and hinder positioning of a probe for shock wave generation.
Described in Jpn. Pat. Appln. KOKAI Publication No. 62-14843 (Patent Document 8), moreover, is an example in which a sucker that is attached to the distal end of an endoscope channel is brought into contact with a calculus to suck it, whereby the calculus can be fixed in front of the channel during a lithotriptic operation.